Monday, June 18, 2012

UP DATE: 6/25/12 Read comment reply on what to do if you choke in a restaurant!

Sunday was a special day to honor fathers -- those present in our lives and/or those who live on in our memories. Fortunate are those who are able to enjoy family get-togethers -- often with several generations enlivening the gathering. Hope each of you enjoyed the day in whatever manner has been meaningful to you.

I didn't forget the day in which we pay tribute to those significant fathers in our lives. My thoughts have been with my East Coast life-long dear friend whose husband, a father and grandfather, passed from this life a few days ago. Their sons, all fathers themselves, were gathered around. I'm sure their families would have been together with their mother for that poignant day -- so soon after their father's death. I'm reminded again to treasure the time we have with one another.

The day for me was unique as I journeyed down a partially clogged freeway to the city of Orange for my required cardiopulmonary resuscitation (CPR) certification two year renewal in an American Heart Association class. I'd previously taken CPR through other organizations, but this is the third renewal I've taken with this particular AHA instructor who continues to be the best I've experienced. The CPR technique has changed through the years as medical research has revealed the most beneficial administrations shown to save lives.

The current criteria for applying CPR is not only more effective but has been simplified. We receive training to provide emergency aid to infants, children and adults. Recent years training has included use of an Automated External Defibrillator (AED.) Ability to provide the Heimlich Maneuver for dislodging airway obstructions has always been part of the program.

I've never been in a situation that requires I administer CPR, or an AED either professionally or personally. I had thought I might be faced with that need only a few years ago on Hawaii's Big Island. We arrived in Kona at night and as our car climbed the narrow two lane winding coastal road toward Hilo we rounded another sharp curve. Suddenly my driver son's voice sounded alarm that he thought he saw a man waving his arms and heard him yell, "help." We pulled to the side of the road, established there had been an accident with a car nosed into a tree off the road and proceeded to determine what help might be needed.

The father of this family was standing outside his car saying he thought he was okay, but was concerned for his wife and adolescent daughter. None of the three evidenced external bleeding injuries or obvious broken bones, but the females seemed especially unnerved as might be expected. The daughter complained of a slight headache having bumped her head against the back of the front seat. My son had immediately phoned for emergency help, but given the location was told considerable time would pass before help could arrive. We never had a thought other than to wait with the family though there seemed to be little we needed to do.

Meanwhile, another car stopped with a man who upon learning of the situation walked around the curve with his flashlight and began signaling visible cautions to all cars coming from either direction on this hazardous roadway. The accident victim said another car had forced him off the road in an account which he described also to the police officer who arrived before the emergency vehicles. After my son's report of our involvement only as helpers, confirmed by the accident victim, and the medical help appeared, the officer said we could leave.

I've always wondered if the daughter was okay, and hoped she was. Before the help arrived she had seemed to be getting sleepy. Other than the slight headache she had no other symptoms, but medical personnel would have determined if she might have experienced a concussion or even internal bleeding -- closed head trauma.

In a situation years earlier, I was sitting at a restaurant counter with friends when I overheard a woman sitting at a small table behind me inquiring of her friend whether she was alright. There was escalating anxiousness from the concerned woman in the minutes following about what to do. The mid-level restaurant chain's young manager with whom we had been talking was observing the women with concern but hadn't concluded action was warranted. As the situation developed, finally I turned to view the women and quickly concluded someone needed to act. I told the manager, you need to call 911 now -- that woman is having a stroke. She was still sitting upright in her chair when the emergency personnel arrived and took her to the hospital. The next day I learned she had a massive stroke - cerebral vascular attack (CVA) or brain attack -- from which she did not survive the night.

Interestingly, the restaurant manager said his hesitation in calling for help was based on corporate guidelines. If the manager phoned the restaurant would be expected to pay for the emergency call and transportation if the customer/patient didn't absorb the cost for any reason.

Many years prior to that situation, before I entered my present profession or had CPR training, my immediate family and I were seated in a booth at our local deli for dinner one evening. My son and I had the outside seats opposite each other. We had finished ordering when I looked up at this silent adolescent's face which had a startled wide-eyed look accentuated by a slackjawed open mouth. Instinctively I gestured and we both stood simultaneously. I understood the respiratory system and placed my closed fist against his diaphragm, giving a forceful sudden push which forced air to exit his mouth dislodging the offending obstruction -- a lifesaver candy!

We both immediately sat back down. This all happened so fast, the rest of the family hardly noticed and I didn't want to alarm everyone by upsetting the mood of the evening, much less scaring my son. I have jokingly commented that I gave him life twice.

(Note: The Heimlich Maneuver is best performed differently that what I did with my son though the concept is the same. I had not been trained on the correct best procedure then.)

The CPR training intends to educate everyone that if a person has an airway obstruction preventing them from breathing they'll put one hand over the other at their throat in a signaling choking gesture. Hopefully, everyone will learn this gesture, but my experience is that not everyone automatically reaches to their throat in a situation when they can't breathe -- certainly my son didn't, but maybe I acted before he might have done so.

I'll be quite content to not encounter any need to provide CPR or require it for myself in the future. In fact, I'll prefer that to be the case. The reality is, that we never know when, where, or under what circumstances we may encounter situations where our assistance is needed, whether or not it's CPR. Or, we may be the ones needing help from another. I think it's likely that others reading this have had much more harrowing experiences than those I relate here which I welcome your sharing.

Saturday, June 09, 2012

A year ago I wrote a musical tribute to “Pianist Bob Allen – Master Musician.” Some of you who
commented then had asked questions about Bob's medical challenges which I'll answer here. Meanwhile, here's an encore performance of Bob's magnificent arrangement of “One Less Bell to Answer” in his inimitable piano
style.

The good news is that Bob Allen has released a recording of the music
from Jesus Christ Superstar he
arranged as a suite in the early 1970s.
The music was requested as many as two or three times each night while
he was performing at Columbus’ Christopher Inn -- the place to be then in
Columbus, Ohio. The suite is still being
requested according to his website. (Before then, when
we left Columbus, my husband had played acoustic bass accompanying Bob .)

Here's Bob talking about one of his most requested arrangements that he recorded:

Bob Allen presents the suite, Jesus
Christ, Superstar, that can be downloaded for a modest amount from this link to his
website: Bob Allen Trio. I'm sharing this information about Bob’s suite being available for purchase, which I don't usually do on this blog, because I’ve always greatly appreciated the music this talented
artist creates. Also, he and his music
have special personal significance to me as I’ve previously written. Additionally, I admire his continuing
dedication to share his talent despite the roadblocks presented by health
problems. Even the best of us at any age encountering the health and financial issues with which Bob has been coping would be challenged, especially during these times.

By way of review -- a special “Pianos for Bob” concert occurred in
Columbus featuring 12 of Central Ohio’s best piano players early last year with
the musicians and the community rallying to Bob’s support. He had experienced a major life challenge with
medical issues beginning “... around 2003, when he underwent heart-bypass
surgery. Diabetes and circulatory
problems followed,” as Joe Blundo, wrote in an excellent article for the
Columbus Dispatch, a major Ohio newspaper.

Bob’s wife of six years, Mickey, is quoted by Blundo as observing her
husband’s “stubborn” nature influencing his unwillingness to use a walker,
except at home, as his physical condition declined. He wasn’t using that walker six years ago
when he generously played at my husband’s celebration of life, or later that
evening when his jazz group played at the Hyde Park Steak House in Upper
Arlington where his trio played regularly in recent years. Eventually, Bob, blind since birth, had both
legs amputated. His positive attitude
and adaptation is attributed to his resilience as Blundo reported.

Overcoming the physical deficits here’s a video of Bob Allen playing with a specially created device to enable
him to use one of the three piano pedals – the most important sustain pedal. Specifics about the design of this piece of adaptive
equipment are provided in an interesting article by creator Rick Brunettoat Bob's website.

eHH

Rick aspired to working with Bob, a goal achieved by this young jazz musician in 1974. He performed and
recorded with Bob for over 13 years before joining the faculty of Denison
University, a private Ohio institution which in my youth I had always hoped I
could attend but events evolved differently.

Brunetto writes extensively about his friend and mentor, describing efforts
to provide Bob much needed support. Rick initiated a 12 pianist musical tribute during the critical recovery time following Bob’s
below-the-knee leg amputations. The
lengthy recovery, loss of income and special housing needs necessitated that
Bob sell his home to move to a one level accommodation. Marketing his
home in the prevailing housing climate was less than ideal. I'm sure community support has been greatly appreciated.

Bob is, hopefully, continuing to create his original compositions and special musical interpretations while successfully adapting to aging adjustments, health changes and the financial challenges of this economy.

Monday, June 04, 2012

Adapting to digital technology has been and continues to be a fascinating and challenging undertaking for many people who once were on technologies cutting edge in the years before personal computers.

I've been delighted that a family member whose professional life included 1950's then state-of-the-art electronics technical activities has been able to resume some computer use. He had been involved many years ago in the space program precursor to NASA associated with unmanned satellite tracking stations. Many years later, following retirement, he had begun developing his computer skills once Internet access connections became available.

His beginning efforts to write his WWII recollections came to a halt when he experienced a life-threatening brain aneurysm from which he was not expected to recover -- but he did! A regimen of various therapies eventually ended and he returned home, but various residual effects greatly curtailed his activities. Eventually he managed to attempt playing the computer's solitaire card game. In his eighties, visual complications unrelated to his previous brain event, hampered his technical skill development.

Eventually, cataract surgery partially corrected some visual deficits allowing limited increased computer use with repeated trials. A year or so ago I had urged consideration be given to his using Skype with assistance, but received no acknowledgement my suggestion had received interest from anyone. I was delighted earlier this year to receive a Skype call from this family member. I've had a few subsequent ones, including last night, from this family member who has actually been able to retain and sequence the steps to make the call, adjust the picture and make other minor corrections.

We sometimes use the Skype short typed messages. Also, initially he was a bit anxious with our audio since he often required repeats due to his hearing loss which is unaided and not responsive to amplification. Occasional repeated calls to me, plus regular frequent calls with his adult children scattered about the country have resulted in his increased confidence and significant lessening of any stress associated with needing to ask for a repeat. By the same token, I make every effort to communicate in ways best for him.

Not only is this exciting to me on a personal level, but professionally it significantly demonstrates that the human brain can continue to recover from insults of many types, such as this aneurysm or a stroke, at any age with dedicated stimulation. I hasten to add there can be many variables that may interfere or prevent some individuals from achieving gains, so we shouldn't be judgmental toward anyone whose skills remain static.

Therapeutic intervention after an event does provide instruction for independent practice once therapy concludes. Consultation with a therapist long after the initial therapy can sometimes be appropriate, but it may be challenging to obtain financial coverage. Generally, Medicare and insurers require there must be some change in function that can be documented. Consult your physician.

My husband had accepted digital technology when our adult children gifted him with a new clock radio, then a compact disc player which renewed his interest in listening to music, generally jazz. When video tape recorders (VCR) became prominent he was less than enthusiastic when I gave him one, so I ultimately figured out how to install the connections to our older TV.

With the installation completed and video tape movies I played a few times, he gradually became interested to the degree he not only used the VCR himself, but acquired knowledge of operational fine points I hadn't learned. Privately amusing to me, was that he would then become impatient if I failed to use the VCR remote special features as efficiently as he had become. We went through this same process when I gave him a DVD player another year.

When our son and wife presented us with one of their desktop personal computers after buying a new laptop, we were quite confident that it was only a matter of time before our man would become adept and enthusiastic using this latest digital technology. Maybe this would help distract him from the constant wearing pain he was experiencing that no longer responded to epidural treatments as he tried also to avoid excessive pain medications and sleeping pills. Unfortunately, he wasn't a candidate for surgery.

At the local office supply store, after choosing a small compact desk, my son and I carefully selected a desk chair that we thought would be most comfortable sitting for my husband, since he was experiencing increasing back pain and other medical problems. When we brought the firm but cushy chair home he did try sitting at the computer, but disappointingly, given our efforts, he was unable to comfortably sit for long. Additionally, he experienced visual difficulty focusing between the keyboard and the screen with his bifocal eyeglasses. I'm sure his constant wearing pain short-circuited his concentration and patience for acquiring new skills, too.

During those early weeks of my computer use, my own limited internet surfing had revealed specific sports and jazz music sites that I thought would garner his interest. I also realized, my goal now had to be not only learning to use the computer myself, so I could help get him started, but that he would need one of those laptops coming onto the market. Wireless capability for home use was beginning to be touted as a possibility, so I concluded this was a system combination we needed.

My plan was that my husband could use a laptop in the relative comfort of his recliner. Meanwhile, to aid in my overcoming computer operation complications our son consulted remotely with me as he was able from his Midwest home, as did my daughter from the East Coast, between the hours of my part time work and other activities here on the West Coast. Also, I benefited from consultations with bloggers who generously shared their knowledge, time, encouragement and emotional support.

For numerous years I had become personally aware of how the wear and tear of constant pain, whether mild or strong, on a person's psyche can effect their attitude toward life and influence their behavior toward others, especially loved ones. Even the individual's thinking can be altered, making their concentration a tiring effort. Frustration, anger toward themselves could manifest itself by being directed toward their most trusted other.

I thought once a select few Internet sites were set up and easily accessible they might serve to draw my husband's attention to enjoyable features outside the pressing discomfort, thus distracting his focus from himself. But before wireless readily became available, or I had a laptop, he went to bed one night and didn't awaken in the morning as I've shared here before in "Time To Talk."

I think of the how the smart phones and tablets available today are even more portable. These devices provide Internet access benefiting individuals of all ages and most capabilities. Anyone interested in developing computer operating skills can likely obtain assistance from a variety of sources. I continue to be amazed at the rapid evolution of new products that have emerged in these six years, leaving me to wonder what's next?

The computer tablet has already become an effective teaching tool attracting
some autistic children to express themselves, even stimulating their speech. Elders have easily
learned to use a tablet's touch screen as their first computer. I may
even be able to use a tablet with some of the individuals for whom I
provide speech, language and cognitive services.

I'm familiar with a retirement community that recently installed wireless service
throughout the campus, including in their skilled nursing health center (SNF.) People sometimes do not realize some SNFs may have very mentally competent residents, some of whom may be able to go about on motorized scooters and leave the facility on outings with friends and family. Residents and people from the community come to the SNF for rehabilitation following some decline in function, generally due to medical changes ranging from dehydration to recovery from surgery and strokes to name a few issues. Some people will recover enough to return to their
previous residences or other living environments. Some individuals requiring more nursing care may remain
permanently.

I've encountered a few SNF residents using their own personal computers. I recall a former Chicago radio broadcaster who actively used her computer to maintain contact with her network television newsman son in his travels. Well into her nineties with mental faculties intact she once expressed concern about whether or not at her age she should still be reading so many newspapers, magazines and other publications about current local and world events. The answer was, of course, "yes!" since she derived so much pleasure from an activity that was such an important part of her life.

Then there was another SNF resident I often noticed up in a chair typing at her computer. She was engaged in writing a book she self-published that I wrote about several years ago:"Salute To Janis David Cooley."

I continue to anticipate much promise for increased activities, pleasure and enjoyment for a select number of skilled nursing facility residents, whether short term or permanent, with wireless connections, tablet computers and, for some, perhaps even a smart phone. I'd best be purchasing these latest digital items myself so I can be prepared, but perhaps there will be some new digital device replacing those before my purchase. Stay tuned.

Friday, June 01, 2012

The News and Politics category at BlogHer is engaging their readers on the topic of the upcoming 2012 Election. Their writer's observation has been that individuals often write what they do want, but some may prefer to express their thoughts by saying what they don't want to occur in this election and/or to our nation. I'm reminded of what's occurring politically in California.

The time is ripening for California political campaigning to intensify, since our Primary Election is upcoming Tuesday, June 5th. This will be our State's first election since redistricting changes. Also, Primary Election voters can now vote across Party lines. Another major Primary change is that the winners will be the top two vote-getters regardless of political party. I supported these changes, but such a system is not without risk. Many candidates for an office could result in a vote split allowing final candidate selections in November to be individuals least preferred by a majority of voters. All those who cast their ballot for those candidates who were eliminated might have had a total vote count greater than either or both winners received

Below is a comment I wrote rather quickly at BlogHer, so is far from inclusive about what I do want candidates to discuss in this 2012 election. I thought with all the election issues this year maybe I should have
more across-generations discussions. Exchanging views seems to me would be
important since many of the blogs I usually encounter reflect similar points of view to mine.

What do you think? Are you able to have civil discourse with those who have different views than yours?

(Your comments are welcome here and/or there, but you'll need to register with BlogHer which I did several years ago. I don't know what specific aspects of the political discourse they'll introduce, or how frequently in the future. They seem to be a primarily younger women's site, do have a "Senior" sub-section under their Life category -- where I recently commented, also. Men are welcome at BlogHer, too, the last I knew. Ronni Bennett at "Time Goes By" wrote some guest blog articles there a few years ago engaging some younger readers in some interesting dialogue.

I do want to hear a REAL debate on issues between Presidential candidates.

I do want them to discuss the critical issues facing this nation.

I do want them to avoid injecting social issues into the conversation as a way to divisively distract voters.

I do want to know the contributors names to all Super Pacs.

I do want Social Security preserved (not changed to private investing) for the sake of my children and their children, generations to come, as can be done despite rhetoric to the contrary.

I do want health care coverage plans for all to be increasingly made available and not cut as promoted by some.

I do want a Congress committed to working together to solve the nation's problems instead of focusing on being obstinate.

I do want Congress to institute a combination of budget cuts and revenue increases that address our deficit in gradual stages and not in one gigantic traumatic action.

I do want to see the middle class re-established in this country (remember the 99%.)

I do want to see tax rate increases for the 1% as Warren Buffett and others affected believe to be warranted in this time of our nation's need.

I do want to see wasteful subsidies such as with the oil industry reduced or eliminated since those companies are making millions in profit.

I do want to see budget reductions in military spending which even they say are warranted.

There are a lot of other matters I want and others I don't want, but this is a start.